On March 26, Dr. Maheen Malik, Senior Technical Advisor for the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program and Management Sciences for Health (MSH), briefed the Congressional Women’s Caucus on strengthening the health workforce in fragile countries. This blog is re-posted from the MSH website.
It can be easy to take healthcare workers for granted. For the majority of us living in the United States, you know that a trained doctor and nurse will see you when you need assistance; a lab technician will do your blood work; and a certified pharmacist will dispense your prescriptions. But imagine going into labor and not knowing if a midwife or doctor will be present? Or, if you need a medication and there is no pharmacy to provide it?
These are the challenges facing millions of people in low- and middle-income countries—and the problems are made worse for those living in rural areas and/or fragile states.
TRAINING HEALTH WORKERS
To address this ongoing challenge, MSH, with International Medical Corps and the Frontline Health Workers Coalition, organized a Congressional briefing with the Congressional Women’s Caucus on March 26: “Saving Women’s and Children’s Lives: Strengthening the Health Workforce in Fragile Countries.”
At the heart of the discussion was the acknowledgement that to save lives you must have a strong health system and a strong health workforce.
Trained medical personnel, including local pharmacists and community health workers, provide needed, accessible, and vital care to millions of women and children during times of instability or natural disasters. The panel of experts looked at how the US government, local governments, private sector, and NGOs are working to ensure a strong health workforce in some of the most difficult places in the world: Pakistan, South Sudan, and Afghanistan.
SUPPORTING AND RETAINING TRAINED HEALTH WORKERS
How do you keep trained health workers? Countries train thousands of health workers each year—just to see 50 percent of them leave the country or the region, said panel moderator Christine Sow, Executive Director of the Global Health Council. Sow stressed that it’s not enough to train professionals; we must remember that health care workers have their own personal and professional challenges, and that they are just as affected by natural disasters or political instability as the people they serve.
It’s imperative that housing and schooling is available for the families of health workers so they can commit to working in rural and challenging areas.
STRENGTHENING THE HEALTH WORKFORCE
The US has a great leadership and technical role to play in promoting the use of health workers. Angeli Achrekar, Senior Advisor in the Division of Global HIV/AIDS at the Centers for Disease Control and Prevention (CDC), discussed how the CDC works in partnership with local governments to strengthen and build health workforces. The CDC and its partners oversee planning and management of local workforces; provide pre-service education; improve quality of training and mentorship; and provide appropriate incentives for retention and performance. The advising and support of country governments has has led to noticeable improvements in many situations.
INVOLVING LOCAL PARTNERS
International Medical Corps also recognizes that local partnerships are key to addressing health workforce challenges. The international NGO works closely with local communities to provide a holistic approach to strengthening health systems, increasing capacity, and providing much needed tools and resources. Ann Canavan, Director of Health Policy and Practice, showed how International Medical Corps is increasing the number of midwives in places with a high mortality rate during child birth, like South Sudan and Afghanistan. This directly addresses the importance of health workforce mapping (a survey of the numbers and locations of the health workforce)—a simple yet key factor for reducing infant mortality.
Maheen Malik, a Senior Technical Advisor for MSH and the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, discussed work MSH is doing in Pakistan, a country where there is one doctor per 1,300 people. Although there are many challenges in Pakistan’s health system, the national government has made health a priority. According to Malik, involving local governments as partners from the beginning is imperative for ownership and success. Through its work in Pakistan, MSH is helping to strengthen regulatory systems, build capacity, accredit pharmacies, and strengthen supply chains. These interventions help to reduce fake immunizations and health drug scams. And the accredited pharmacies are better known by the local people.
This briefing was just one of many discussions to educate Congressional staff on the value and need of frontline health workers to meet all of the US global health target goals. Through our work with the Frontline Health Workers Coalition and the One Million Community Health Workers Campaign, we will continue to advocate for US assistance in addressing the many challenges faced by frontline health workers.
And—in partnership with local, regional, and international organizations—we will continue to strengthen health systems, including by training, supporting, and empowering community health workers in fragile, conflict-ridden states.
Danielle Heiberg is a policy and advocacy consultant at MSH.
Editor’s note: April 7-12 is World Health Worker Week. Join the conversation online with hashtags #WHWW and #healthworkerscount. Learn more about how you can participate with the Frontline Health Workers Coalition’s engagement toolkit (PDF).